Zongshan Hu1,2,3, Claudio Vergari4, Laurent Gajny4, Gene Chi-Wai Man2,3, Kwong-Hang Yeung3,5, Zhen Liu1, Tsz-Ping Lam2,3, Zezhang Zhu1,3, Yong Qiu1,3, Winnie Chiu-Wing Chu3,5, Jack Chun-Yiu Cheng2,3, Wafa Skalli4. 1. Department of Spine Surgery, Drum Tower Hospital of Nanjing University Medical School, Nanjing, China. 2. Department of Orthopaedics and Traumatology, The Prince of Wales Hospital, The Chinese University of Hong Kong, Hong Kong, China. 3. The Joint Scoliosis Research Center of the Chinese University of Hong Kong-Nanjing University, Faculty of Medicine, The Chinese University of Hong Kong Hong Kong, China. 4. Arts et Métiers Institute of Technology, Université Sorbonne Paris Nord, IBHGC-Institut de Biomécanique Humaine Georges Charpak, HESAM Université, F-75013, Paris, France. 5. Department of Imaging and Interventional Radiology, The Prince of Wales Hospital, The Chinese University of Hong Kong, Hong Kong, China.
Abstract
Background: Balanced global spinopelvic balance is important in the maintenance of the physiological alignment of all body segments above the pelvis with minimum energy expenditure. The key determinants affecting the 3D index-odontoid-hip axis (OD-HA) angle, and in particular its alterations, have not been clearly defined. The aim of this study is to identify the determinants of the 3D OD-HA angle in maintaining global spinopelvic balance in a large Chinese adult cohort of different gender and age groups. Methods: A total of 516 asymptomatic adults were enrolled in this study. Biplanar radiographies were performed to reconstruct the subject's inter-acetabular axis and C2 odontoid process. The 3D angle formed by the vertical and the line between odontoid and mid-interacetabular axis (OD-HA angle) was computed and projected in the subject's sagittal and coronal planes. Thoracic kyphosis (TK), lumbar lordosis (LL), T1 pelvic angle (TPA) and sagittal vertical axis (SVA) were measured. Results: The mean values of sagittal and coronal OD-HA were -0.2°±2.5° and 0.2°±1.1°, respectively. Both sagittal and coronal OD-HA had significant correlation with age (r=0.265 and r=-0.143, P<0.01, respectively), sagittal OD-HA showed increment from 20s to 80s (-1.3° to 0.8° for female, -0.3° to 1.5° for male) and a significant difference between male and female from 20 to 69 years old. Further analysis showed that sex, weight, TK, PT, SVA, TPA and ODI were determinants of OD-HA. Conclusions: 3D OD-HA angle showed physiological stability with little variability from young to elderly adults, with SD of 2.45° and 1.06° in sagittal and coronal planes, respectively. OD-HA angle confirms the hypothesis that the head tends to remain above the pelvis in a small cone of stability. This study provides an analysis of the determinants of OD-HA and the reference range of the head-pelvis balance in each decade and gender based on a large-scale asymptomatic population. 2022 Quantitative Imaging in Medicine and Surgery. All rights reserved.
Background: Balanced global spinopelvic balance is important in the maintenance of the physiological alignment of all body segments above the pelvis with minimum energy expenditure. The key determinants affecting the 3D index-odontoid-hip axis (OD-HA) angle, and in particular its alterations, have not been clearly defined. The aim of this study is to identify the determinants of the 3D OD-HA angle in maintaining global spinopelvic balance in a large Chinese adult cohort of different gender and age groups. Methods: A total of 516 asymptomatic adults were enrolled in this study. Biplanar radiographies were performed to reconstruct the subject's inter-acetabular axis and C2 odontoid process. The 3D angle formed by the vertical and the line between odontoid and mid-interacetabular axis (OD-HA angle) was computed and projected in the subject's sagittal and coronal planes. Thoracic kyphosis (TK), lumbar lordosis (LL), T1 pelvic angle (TPA) and sagittal vertical axis (SVA) were measured. Results: The mean values of sagittal and coronal OD-HA were -0.2°±2.5° and 0.2°±1.1°, respectively. Both sagittal and coronal OD-HA had significant correlation with age (r=0.265 and r=-0.143, P<0.01, respectively), sagittal OD-HA showed increment from 20s to 80s (-1.3° to 0.8° for female, -0.3° to 1.5° for male) and a significant difference between male and female from 20 to 69 years old. Further analysis showed that sex, weight, TK, PT, SVA, TPA and ODI were determinants of OD-HA. Conclusions: 3D OD-HA angle showed physiological stability with little variability from young to elderly adults, with SD of 2.45° and 1.06° in sagittal and coronal planes, respectively. OD-HA angle confirms the hypothesis that the head tends to remain above the pelvis in a small cone of stability. This study provides an analysis of the determinants of OD-HA and the reference range of the head-pelvis balance in each decade and gender based on a large-scale asymptomatic population. 2022 Quantitative Imaging in Medicine and Surgery. All rights reserved.
Entities:
Keywords:
3D reconstruction; adult; asymptomatic; odontoid-hip axis (OD-HA); postural alignment
Authors: Jean Dubousset; Georges Charpak; Irène Dorion; Wafa Skalli; François Lavaste; Jacques Deguise; Gabriel Kalifa; Solène Ferey Journal: Bull Acad Natl Med Date: 2005-02 Impact factor: 0.144
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